End the surprise insurance gap

Physicians React to House Energy & Commerce Draft Bill, Urge Congress to Pursue a Proven Solution to End Surprise Billing

Date created

Tue, 05/14/2019 - 12:54

WASHINGTON – Following the House Energy and Commerce Committee’s release of draft legislation addressing surprise medical billing, physicians around the country are urging lawmakers to support an Alternative Dispute Resolution (ADR) process—the only proven solution that protects patients from unexpected, costly medical bills.

Physicians for Fair Coverage (PFC), a non-profit, non-partisan alliance of tens of thousands of physicians, calls on lawmakers to support a legislative solution to surprise medical bills that: Ensures patients are not caught in the middle between providers and insurers; increases transparency and holds patients harmless;

ensures that patients will continue to have access to the best doctors in emergency situations and won’t get surprise bills.

“We appreciate the work of the Energy and Commerce Committee and their commitment that no patient should be burdened with a surprise medical bill for emergency care,” said Dr. Sherif Zaafran, Chair of Physicians for Fair Coverage. “However, of all the solutions being discussed right now, only one has a proven record of success: New York’s Alternative Dispute Resolution (ADR) process. With nine states and counting modeling their surprise billing bans off the New York law, I encourage Chairman Pallone and Ranking Member Walden to consider the testimonials of thousands of physicians serving millions of patients who have seen evidence that ADR is the only solution that ends surprise billing and protects patients from out-of-control charges.”

In less than four years, New York’s bipartisan ADR law has led to stronger protections for patients and more patient-centric health plans; enhanced transparency from health insurers; increased network participation; and fewer out-of-network claims. In fact, in 2013, the out-of-network care rate in New York was 20.1 percent. Two years after the law was implemented, the rate plummeted to 6.4 percent – a 68 percent decrease.

Background:

Each year, millions of Americans seek emergency care at a hospital, and they do their best to ensure they receive care at an in-network hospital covered by their health insurance plan. However, even if patients receive care at an in-network hospital, they could be treated by an out-of-network physician, which may result in what is commonly referred to as a surprise or balance medical bill.

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About Physicians for Fair Coverage

Physicians for Fair Coverage (PFC) is comprised of tens of thousands of physicians in a variety of specialties serving communities in all 50 states. To learn more, visit www.endtheinsurancegap.org.